Corbett's new Public Welfare chief promises openness with Medicaid

HARRISBURG — Gov. Tom Corbett's pick to run the Department of Public Welfare has been on the job for just 14 days.

But that doesn't mean Beverly Mackereth is a novice.

She is a former children and youth caseworker, head of York County Department of Human Services and state representative. She also was deputy director in Public Welfare Department before Corbett elevated her to take the place of her former boss, Gary Alexander, a Rhode Island native who rubbed legislators the wrong way during his two-year stint as public welfare secretary.

That home-grown experience allowed Mackereth to easily handle questions — and deflect criticism of Corbett's decision thus far not to expand Medicaid under the federal Affordable Care Act — during her first budget hearing as acting secretary before the Senate Appropriations Committee on Tuesday.

"You really are a breath of fresh air," said Sen. Pat Vance, R-Cumberland, chairwoman of the Public Health and Welfare Committee.

The hearing focused on Corbett's proposed public welfare budget of nearly $11 billion, about 3 percent higher than this year's. The hearing was expected to draw heated comments and questions from some Democrats upset over Corbett's reluctance to widen the Medicaid program to provide medical coverage to an additional 719,000 poor residents.

State Sen. Vincent Hughes, D-Philadelphia, minority chairman of the Senate Appropriations Committee, has argued that Corbett needs to increase Medicaid under the federal law commonly referred to as Obamacare. Hughes cited a Feb. 22 report by Families USA and the Pennsylvania Health Access Network that estimated increased Medicaid participation would add 41,200 jobs and $5.1 billion to the state's economy, partly because the federal government would pick up the entire expansion tab for the first three years.

But Mackereth was able to blunt a lot of the criticism.

She said 30 percent of Corbett's proposed $28.4 billion state spending plan already would go toward Medicaid and that only Missouri spends more per capita on Medicaid than Pennsylvania. About 2.2 million Pennsylvanians, or one in six, are on Medicaid, she said. Expanding the net would bring the ratio down to one in four, and that would cost the state billions over the next six years, Mackereth said.

"There's no such thing as free money," she said. "It may cost $2 billion; it may cost $4 billion by 2019. We don't know. But it's still taxpayer dollars. We are working to figure it out."

Hughes told Mackereth that one of his biggest complaints has been the administration's reluctance since November to share its Medicaid analysis with lawmakers. Senators need the information to make the best decision for taxpayers and the poor who would be served, he said.

"We've got to get this right," Hughes said. "No one is being cavalier about this."

Mackereth promised an open dialogue with lawmakers.

As attorney general, Corbett joined a multistate lawsuit challenging the constitutionality of a provision in the law requiring people to buy insurance.

In June, the U.S. Supreme Court upheld nearly all aspects of the law. The ruling preserved the so-called individual mandate that allows government to tax individuals who don't purchase health insurance. The ruling also gave states the option of accepting or rejecting the plan to make additional low-income people eligible for Medicaid.

Since then, 24 states have agreed to expand Medicaid. Several of those states, including New Jersey and Florida, have Republican governors who shared Corbett's opposition before reversing course and agreeing to the expansion.

But Florida Gov. Rick Scott's reversal hit a snag on Monday when a state House committee rejected Medicaid expansion and a Senate committee postponed a vote on a bill in that chamber.

Corbett might not have as hard a time with the Republican-controlled Legislature should he reverse his course after meeting with Kathleen Seblius, secretary of the U.S. Health and Human Services Department, over Medicaid issues. A meeting is expected to be held later this month or early in April.

After Tuesday's hearing, House Majority Leader Mike Turzai, R-Allegheny, said Republican lawmakers in his party will follow the lead of Corbett and Mackereth.

"There is a new secretary," Turzai said. "I think the governor will take her input."